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30 The acquired immune deficiency syndrome and epidemic of infection with human immunodeficiency virus: Costs of care and prevention in an inner London district Johnson, A.M., Adler, M.W. and Crown, J.M. Br. Med. .I.; 29316545 (1986) 489-492 The epidemic of the acquired immune deficiency syndrome (AIDS) and infection with human immunodeficiency virus (HIV) necessitates early planning of services and allocation of resources. The use of hospital resources by patients with AIDS and the planned additional costs of clinical and preventive services for the epidemic of infection with HIV were calculated for an inner London health district that has treated 18% of the cases in the United Kingdom. Patients with AIDS required on average 50 days of inpatient hospital care each at an estimated current average lifetime cost of pounds 6800. These costs, however, underestimated the additional capital and revenue costs of planned new preventive and treatment services, estimated as being pounds 388,000 revenue and pounds 472,000 capital for 1986-7. It is important to invest now in preventive services throughout the United Kingdom to reduce the future social and financial costs of AIDS. The federal response to the AIDS epidemic Lee, P.R. and Arno, P.S. Health Policy; 613 (1986) 259-267 The response of the U.S. government to the AIDS epidemic is reviewed within the context of health policy making in the U.S.A. in general and the reduced role of the federal government in domestic social programs in particular. This review involves multiple levels of government, the relationship of government to the private sector, the diffusion of authority within a federal system, the long delays in policy implementation because of the absence of mechanisms to deal with emergency situations, the tendency to fund the response to AIDS from reallocation of appropriated funds, thereby creating financial distress for existing programs. The federal response to AIDS is considered uncoordinated, insufficient and inadequate in particular with respect to the support of public health education and the financing of health care for AIDS patients. These are needed while a vaccine may still be years away. Medical care costs of AIDS in Massachusetts Seage III, G.R., Landers, S., Barry, M.A., Groopman, !., Lamb, G.A. and Epstein, A.M. J. Am. Med. Assoc.; 256122 (1986) 3107-3109 Previous investigation has suggested that the direct cost of medical care for the 24 011 reported patients with acquired immunodeficiency syndrome (AIDS) may be as high as $147 000 per patient. To evaluate the use and cost of medical services for patients with AIDS in Massachusetts, we performed a one-year cost of illness study of 45 AIDS patients. Sociodemographic and clinical data as well as information on medical utilization were obtained from review of outpatient and hospital records. Patients with AIDS required a mean of 3.3 (? 3.2) hospitalizations per year and 18.4 (* 21.8) ambulatory visits per year. Overall, medical costs averaged $46 505 ? $38 720 per patient per year, with 91% of these expenditures related to use of inpatient services. These results suggest that the cost of medical care for AIDS patients may be substantially less than previously estimated. Medical care costs of patients with AIDS in San Francisco Scitovsky, A.A., Cline, M. and Lee, P.R. J. Am. Med. Assoc.; 256122 (1986) 3103-3106 This article reports on the findings of a study of medical care expenditures of persons with acquired immunodeficiency syndrome (AIDS) treated at San Francisco General Hospital in 1984. We found that mean charges per AIDS hospital admission were $9024, mean charges of patients with AIDS who received all their hospital inpatient and outpatient care at San Francisco General Hospital in 1984 ranged from $7026 to $23 425, and mean lifetime inpatient charges of patients with AIDS who died and who had received all their inpatient care at the hospital were $27 571. These latter charges were considerably

Medical care costs of patients with AIDS in San Fransisco

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The acquired immune deficiency syndrome and epidemic of infection with human immunodeficiency virus: Costs of care and prevention in an inner London district Johnson, A.M., Adler, M.W. and Crown, J.M. Br. Med. .I.; 29316545 (1986) 489-492 The epidemic of the acquired immune deficiency syndrome (AIDS) and infection with human immunodeficiency virus (HIV) necessitates early planning of services and allocation of resources. The use of hospital resources by patients with AIDS and the planned additional costs of clinical and preventive services for the epidemic of infection with HIV were calculated for an inner London health district that has treated 18% of the cases in the United Kingdom. Patients with AIDS required on average 50 days of inpatient hospital care each at an estimated current average lifetime cost of pounds 6800. These costs, however, underestimated the additional capital and revenue costs of planned new preventive and treatment services, estimated as being pounds 388,000 revenue and pounds 472,000 capital for 1986-7. It is important to invest now in preventive services throughout the United Kingdom to reduce the future social and financial costs of AIDS.

The federal response to the AIDS epidemic Lee, P.R. and Arno, P.S. Health Policy; 613 (1986) 259-267 The response of the U.S. government to the AIDS epidemic is reviewed within the context of health policy making in the U.S.A. in general and the reduced role of the federal government in domestic social programs in particular. This review involves multiple levels of government, the relationship of government to the private sector, the diffusion of authority within a federal system, the long delays in policy implementation because of the absence of mechanisms to deal with emergency situations, the tendency to fund the response to AIDS from reallocation of appropriated funds, thereby creating financial distress for existing programs. The federal response to AIDS is considered uncoordinated, insufficient and inadequate in particular with respect to the support of public health education and the financing of health care for AIDS patients. These are needed while a vaccine may still be years away.

Medical care costs of AIDS in Massachusetts Seage III, G.R., Landers, S., Barry, M.A., Groopman, !., Lamb, G.A. and Epstein, A.M. J. Am. Med. Assoc.; 256122 (1986) 3107-3109 Previous investigation has suggested that the direct cost of medical care for the 24 011 reported patients with acquired immunodeficiency syndrome (AIDS) may be as high as $147 000 per patient. To evaluate the use and cost of medical services for patients with AIDS in Massachusetts, we performed a one-year cost of illness study of 45 AIDS patients. Sociodemographic and clinical data as well as information on medical utilization were obtained from review of outpatient and hospital records. Patients with AIDS required a mean of 3.3 (? 3.2) hospitalizations per year and 18.4 (* 21.8) ambulatory visits per year. Overall, medical costs averaged $46 505 ? $38 720 per patient per year, with 91% of these expenditures related to use of inpatient services. These results suggest that the cost of medical care for AIDS patients may be substantially less than previously estimated.

Medical care costs of patients with AIDS in San Francisco Scitovsky, A.A., Cline, M. and Lee, P.R. J. Am. Med. Assoc.; 256122 (1986) 3103-3106 This article reports on the findings of a study of medical care expenditures of persons with acquired immunodeficiency syndrome (AIDS) treated at San Francisco General Hospital in 1984. We found that mean charges per AIDS hospital admission were $9024, mean charges of patients with AIDS who received all their hospital inpatient and outpatient care at San Francisco General Hospital in 1984 ranged from $7026 to $23 425, and mean lifetime inpatient charges of patients with AIDS who died and who had received all their inpatient care at the hospital were $27 571. These latter charges were considerably

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lower than previously published estimates of lifetime direct medical care costs of patients with AIDS, and the possible reasons for the differences include much lower lifetime use of hospital services and somewhat lower cost per hospital day.

Estimates of the direct and indirect costs of acquired immunodeficiency syndrome in the United States, 1985, 1986, and 1991 Scitovsky, A.A. and Rice, D.P. Public Health Rep.; 102/l (1987) 517. This study presents three estimates - ranging from low to high - of the direct and indirects costs of the AIDS epidemic in the United States in 1985, 1986, and 1991, based on prevalence estimates provided by the Centers for Disease Control (CDC). According to what the authors consider their best estimates, personal medical care costs of AIDS in current dollars will rise from $630 million in 1985 to $1 .l billion in 1986 to $8.5 billion in 1991. Nonpersonal costs (for research, screening, education, and general support services) are estimated to rise from $319 million in 1985 to $542 million in 1986 to $2.3 billion in 1991. Indirect costs attributable to loss of productivity resulting from morbidity and premature mortality are estimated to rise from $3.9 billion in 1985 to $7.0 billion in 1986 to $55.6 billion in 1991. While estimated personal medical care costs of AIDS represent only 0.2 percent in 1985 and 0.3 percent in 1986 of estimated total personal health care expenditures for the U.S. population, they represent 1.4 percent of estimated personal health care expenditures in 1991. Similarly, while estimated indirect costs of AIDS represent 1.2 percent in 1985 and 2.1 percent in 1986 of the estimated indirect costs of all illness, they are estimated to rise to almost 12 percent in 1991. Estimates of personal medical care costs were based on data from various sources around the United States concerning average number of hospitalizations per year, average length of hospital stay, average charge per hospital day, and average outpatient charges of persons with AIDS. For estimating the indirect costs the human capital method was rates of persons with AIDS were the same as those for the general population by age and sex.

Coat transfusionnel du SIDA: Exp&ience de I’H6pital Claude-Bernard g propos de 28 cas Cost of blood products in AIDS patients: a review of 28 cases followed up in Hopital Claude Bernard Simmonneau, M.; Regnier, P.; Vittecocq D. et al. Rev. Fr. Transfur. Immune-Hematol.; 2714 (1984) 557-560. The study of 28 confirmed cases of AIDS shows that transfused patients use a large amount of hospitals blood products, especially platelets. For these patients, the average cost of transfusion is higher than that, for intensive care unit patient’s The use of irradiated products increases the cost (2 35%). As there is a shortage of donors, if the present precautions are respected, there is no reason why the hospital should not continue to ask the patient’s family and circle of friends, to donate blood.